Hi all.

So sorry for the long post. I'm new and dumb :-)

I am amab / mtf, and have never seen a doctor or therapist regarding any gender treatment (having instead used "alternative"means for hormones)

I was on hrt for a bit longer than a year, and was progressing well (both physically, and mentally), and was ready to go see a doc for proper care, but was instead forced to go off hrt for almost two years. This has led to a whole new level of disphoria for me, since I watched the "regression" in the mirror, as it were.

I've been reading a lot about Kaiser benefits for transgender and gender nonbinary patients and have began to feel somewhat empowered to resume my transition, since it seems that they provide a good environment and are at the forefront of care.

I have a therapy appointment the middle of this month. This appointment is for something entirely unrelated to gender treatment or reassignment. (I've developed severe PTSD symptoms after a serious accident that happened earlier this year)

I've been thinking of asking for a referral to the Kaiser San Francisco gender clinic once I've addressed the other issues with my new found psychologist. (Although I would like to address my gender disphoria immediately, I am unable to bring the topic up until I have a good grip on the Anxiety / ptsd disorder)

So, on to my questions:

Are there any folks here with experience with Kaiser treatment and protocols?  Patients at the NorCal clinics, perhaps? Hope someone could share their experiences if so.

Will Kaiser prescribe injectable medications for self administration (I prefer this method), or is that a no-no for them? I really hate the thought of having to go in for injections every 10 days- not sure I can do that.

Does Kaiser subscribe to a strict "gatekeeper" style, or are they more of a informed consent/ harm reduction model of treatment?

Thanks to all for reading, and for your thoughts.

I'm in the Kaiser NorCal program.  They use a modified informed consent, with an intake session and one or more additional sessions, after which you should be able to get a referral to Endocrinology. 

My particular clinic is well outside San Francisco, but my therapist happens to be on the staff of the Oakland, CA Multi-Specialty Transitions center Kaiser operates there.

I don't know about the self-administered injectibles, as I'm a (rare ) successful patch user.

Let your therapist know about your transgender nature and desires, so they can get it on the record for use in referrals.

The Kaiser NorCal program has some funny timeline things, like requiring one to be on an anti-androgen for 6 months before they'll check eligibility for hair removal. They do have several electrolysis contractors they can work with in the region.

The program is also in the process of moving laser hair removal in house, along with FFS and GCS. They have been contracting this out, but I suspect the insurance side was squawking about sending all those patients to Arizona.

Thank you for such a quick reply.

I'm somewhat north of San Francisco, so I'm only assuming that that would be the likely location I'd be sent to. (We live in a bedroom community north of the city, but do have a really good Kaiser facility here too)

I'm thrilled to hear that they are providing ffs and hair removal at all; do you happen to know if these (and any other procedures) are generally covered with most of their standard plans?

(I know the SF city employee's plan is  VERY Trans friendly... And has been for quite some time; Our particular plan, I'm not really as certain)

Hopefully they will provide for self injection - I can't wear a patch - the adhesive really does a number on my shin.... (I don't really do well on higher doses of spiro either- hopefully they can provide a better alternative, since no Cyproterone from the docs )

Thanks again!

The different Kaiser plans vary in copayments, max out of pocket costs, and such on the insurance side of things, but on the medical side, it's all the same.  I'm on a high deductible HSA eligible individual plan (bought through CoveredCa.com), but I get the same care as everyone on employer plans, Gold plans, etc.

The only variations are in the bills and the copayments I get asked for when I check in.

Kaiser is very Trans-friendly.  My medical record has footnotes on my gender and first name, so most places where I check in I get named correctly, with the right pronouns.  The pharmacy, alas, has to use legal names, so until I get the legal paperwork done I have to deal with that.  Nobody so far has even batted an eye when I show up dressed properly, even though I don't remotely pass.

I'm up in the northeast bay/delta area, and the facilities here are all good.

I'm pretty sure they'll support self-injection.  They have training classes, even.  You'll want to work with your endocrinologist on the drugs once you are assigned on and in 'the system'. The ones that work with the transgender community seem pretty good.

The doctors, therapists, and endocrinologist I've seen so far are actually not at the Multi-Specialty Transitions center, at least not full time.  They've been at the regional medical center, so that has been pretty easy for me.  There's a group session that meets regularly at that center, too, with everything from post-op to pre-everything folks.

Oh, by the way, Welcome!      This is a really great site to share information and resources, and there are lots of friendly and helpful folks here.   I bet one of our moderators will be along shortly to welcome you and share some links to even more neat stuff.

- Michelle

Grey Rain,

Welcome to the site.

I am glad you got some answers to some of your question s right off. Our site tries to avoid discussion of self medication and dosage information. That is part of our Terms of Service.

I also to share some links with you. They are mostly welcome information and the rules that govern the site. If you have not had a chance to look through them, please take a moment:

Site Terms of Service & Rules to Live By	Standard Terms & Definitions	Post Ranks (including when you can upload an avatar)
Reputation rules	News posting & quoting guidelines	Photo, avatars, & signature images policy

Once again, welcome to Susan's. Look around, ask questions and join in.

With warmth,

Joanna